Purpose: We investigated the associations of ten previously identified high risk molecular lipid species and three ceramide ratios with the occurrence of major adverse cardiac events (MACE) during a median follow-up of 4.7 years in patients with coronary artery disease (CAD). Methods:Between 2008 and 2011, 581 patients underwent diagnostic coronary angiography or percutaneous coronary intervention for stable angina pectoris (SAP) or acute coronary syndrome (ACS).Blood was drawn prior to the index procedure and lipid species were determined. The primary endpoint was the occurrence of MACE, comprising all-cause mortality, nonfatal ACS or unplanned coronary revascularization. The secondary endpoint comprised all-cause mortality or nonfatal ACS. Conclusion:Altogether, the circulating ceramide lipids we investigated here are associated with adverse cardiac outcome during long-term follow-up independent of clinical risk factors.

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The temporal pattern of circulating miR-22-3p contains important prognostic and independent information in CHF patients. This concept warrants further investigation in larger series with extended follow-up.